Great. Just what we needed when Vietnam Vets are falling like flies. This is akin to hurry up and pre-deny boots on the ground folks-not to mention Korea/Anderson Is. and any bases stateside. It never ceases to amaze me what VA/QTC et al will do to prevent claims from reaching fruition. When they get busted, no one is held accountable. It’s just an unfortunate mistake and the miscreants will all be counseled such that it never occurs again- well- with that particular disease/ injury.

The track record is one of obfuscation, concealed data, top-sheeted files reviews (as here) and worse. I always like to point to my case and show that VA made every attempt to ignore factual evidence of my presence in Vietnam and points north. You don’t have to deny the disease if you can prove that the Veteran was never there. That really falls into the “absence of evidence is not negative evidence” crevasse. VA uses it to great effect.

Nevertheless, the toll on us continues to rise. It’s now estimated that Vietnam Vets are either dying from disease or their own hand to the tune of over 15 a day. If you drew the short straw with VA and lost, there isn’t much point in soldiering on, apparently. You do have to admire VA for using QTC as the fall guy on this. That is deniability to the Nth degree.

I don’t exactly understand the concept of “absence of evidence is not negative evidence” because the VA used that exact concept to deny my SC related dental problems. The Army/VA alliance lost half my medical records including 3 weeks in the hospital for some kind of lung disease that killed a few guys in basic training in 1971 at Fort Lenardwood. You know General Lenardwood was one of our first war criminals. He and his men surround a crater where insurgents Morro fighters were holed up. His men annihilated all the Morro fighters down to the dogs and cats. Just like in the Middle Ages when the Pope had the Cathars wiped out to the last soul. Mind my spelling. I hope you get the idea.

The concept came from a CAVC HCV case. The Veteran had no evidence in the STRs that he had cut himself shaving while sharing razors in the field in Vietnam. The Appellant’s argument was that the risk factor (commingling of blood) would not be expected to be in the records as most Military soldiers cut themselves eventually shaving with no adverse outcomes. The burden of proof argument is cemented when you prove that it would be incongruous to report to sick call with a shaving cut-especially in a combat environment.

I remember I was denied for TMJ due to the fact the dentist that told me what I had during an Army exam was careful not to include a DX in his exam notes. All he wrote was ” Dental exam” with no DX or any other notes. Of course the VA denied the claim since the dentist scared me half to death (I was 19 years old) by telling me the only treatment in 1971 for TMJ was to put two bolts in my jaw and I would look like the Frankenstein monster. I had had a horrible experience with an Army dentist about 6 months prior in which the dentist tried to do a tooth transplant on me using a compacted wisdom tooth to fill the hole where he had pulled my rear left molar instead of trying a crown and root canal. Just recently the VA dental department told me that they did not do dental implants because they are experimental. I have three implants which I paid for out of my pocket rather than let the VA just pull the teeth which would inevitably result in dentures down the road. Quick fix for vet dental problems just pull the teeth and replace with dentures. I actually have pretty good teeth but to hear the VA half should be pulled.

I was denied on cardiac as secondary to DMII (AO) by a nurse practioner who was training another NP at the same time. No tests at all. The NP just asked me if I could walk two blocks. I said “yes” since I had to walk that far just to the C&P exam after finding parking. I appealed and got some testing. Within a year I had 60% for CAD. This was in around 2006, and I have never seen a VA cardiologist in all the time since. I have a private cardiologist, dentist, sleep doctor, Primary care doctor, eye doctor , psychiatrist, psychologist because VA’s doctors are totally incompetent IMO. Why use the VA when they bill my private insurance anyway for substandard care?

Here is how, in part, it works. The Veteran is “required” to attend a C and P exam. Non attendance is “automatic” denial. As the article points out the QTC “doc” gets $300 OR $350 for an exam that sometimes lasts 15 minutes or less, with the examiner “supposedly” qualifed to make an opinion.
The examiner is given a “presumptive” that he is qualified absent a challenge from the Veteran, even if the “examiner” was the the plumber unclogging the sink who happened to be there when the “doc” went to play golf.
Mine was such a case. The examiner had exactly “0” medical training or medical experience in sleep apnea, or sleep medicine, but never you mind..as she gave evidence to deny anyway. She explained she had “researched” sleep apnea online (google search), so she was qualified to opine.

The examiner collected a nice salary amounting to about $600 per hour, as the exam was under 30 minutes. The VA got their evidence to deny, so everything is in order, according to VA. Here is the problem with all of that.
The VA justifes the high cost of the C and P exam because the “doc” has a high level of specialized experience, right? Not so much. Many are nurse practioners, or even less, and dont treat patients at all. They just cut and paste “denial language” into your exam.
They dont need “tests” such as xrays, PFT tests, ROM tests, etc. All they need is negative evidence, that is, your SMR’s were “negative” any activity of this malady in service. But wait! What if the C and P exam is within a year of service? Does this not mean a presumptive that this malady occurred in service?
And, what about an increase? Does the ROM not need to be tested? What about degenerative arthritis which may have worsened? Is an xray or MRI ordered? Probably not. VA does not need that…they already have the absence of evidence means negative evidence.